Systematic Reviews

Once the screening process is complete, the review team need to investigate selected articles for quality and bias. Because systematic reviews rely on data from other studies, the evidence in a systematic review is only as good as, or as free from bias as, the included studies. This means that the methodological quality of each paper included in a systematic review should be assessed. This process involves appraising, judging, and documenting potential risks of bias.

There are tools that can be used to assess quality and bias listed below.

• The most important thing to remember when choosing a quality assessment tool is to pick one that was created and validated to assess the study design(s) of your included articles.
• Pick a quality assessment tool specifically designed for your inclusion/exclusion criteria. 

Risk of Bias / Quality Assessment Tools

Systematic Reviews and Meta-Analyses

• JBI Critical Appraisal Tools
  Critical appraisal tools for quality assessment of a wide variety of study designs.
• AMSTAR Checklist
  A 16-question measurement tool to assess systematic reviews
• AHRQ Methods Guide for Effectiveness and Comparative Effectiveness Reviews
  The AHRQ Methods Guide for Effectiveness and Comparative Effectiveness Reviews, provides detailed information on selecting eligibility criteria, searching the literature, data extraction, quality assessment, and other steps in the creation of a systematic review.
• CASP - Systematic Review
  A checklist for quality assessment of systematic review from the Critical Appraisal Skills Programme
• Scottish Intercollegiate Guidelines Network (SIGN)
  Checklists for quality assessment
• LEGEND Evidence Evaluation Tools
  A series of critical appraisal tools from the Cincinnati Children's Hospital. Contains tools for a wide variety of study designs, including prospective, retrospective, qualitative, and quantitative designs.

Clinical Practice Guidelines

• National Guideline Clearinghouse Extent of Adherence to Trustworthy Standards (NEATS) Instrument
  A 15-item instrument using a scale of 1-5 to evaluate a guideline's adherence to the Institute of Medicine's standard for trust worth guidelines
• AGREE-II Appraisal of Guidelines for Research and Evaluation
  The Appraisal of Guidelines for Research and Evaluation (AGREE) Instrument evaluates the process of practice guideline development and the quality of reporting

Randomized Controlled Trials (RCTs)

• Cochrane Risk of Bias (ROB) 2.0 Tool
  Templates are tailored to randomized parallel-group trials, cluster-randomized parallel-group trails (including stepped-wedge designs), and randomized cross-over trails and other matched designs.
• CASP- Randomized Controlled Trial Appraisal Tool
  A checklist for RCTs created by the Critical Appraisal Skills Program (CASP)
• The Jadad Scale
  The Jadad scale assesses the quality of published clinical trials based methods relevant to random assignment, double blinding, and the flow of patients.
• CEBM-RCT
  A critical appraisal tool for RCTs from the Centre for Evidence Based Medicine (CEBM)
• JBI Critical Appraisal Tools
  Critical appraisal tools for quality assessment of a wide variety of study designs.
• Scottish Intercollegiate Guidelines Network (SIGN)
  Checklists for quality assessment
• LEGEND Evidence Evaluation Tools
  A series of critical appraisal tools from the Cincinnati Children's Hospital. Contains tools for a wide variety of study designs, including prospective, retrospective, qualitative, and quantitative designs.

Cohort Studies

• CASP- Cohort Studies
  A checklist created by the Critical Appraisal Skills Programme (CASP) to assess key criteria relevant to cohort studies
• JBI Critical Appraisal Tools
  Critical appraisal tools for quality assessment of a wide variety of study designs.
• The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses
  Validated tool for assessing case-control and cohort studies.
• Scottish Intercollegiate Guidelines Network (SIGN)
  Checklists for quality assessment
• STROBE Checklist
  A checklist for quality assessment of case-control, cohort, and cross-sectional studies
• LEGEND Evidence Evaluation Tools
  A series of critical appraisal tools from the Cincinnati Children's Hospital. Contains tools for a wide variety of study designs, including prospective, retrospective, qualitative, and quantitative designs.

Case-Control Studies

• CASP- Case Control Study
  A checklist created by the Critical Appraisal Skills Programme (CASP) to assess key criteria relevant to case-control studies
• STROBE Checklist
  A checklist for quality assessment of case-control, cohort, and cross-sectional studies
• Tool to Assess Risk of Bias in Case Control Studies by the CLARITY Group at McMaster University
  A quality assessment tool for case-control studies from the CLARITY Group at McMaster University
• Scottish Intercollegiate Guidelines Network (SIGN)
  Checklists for quality assessment
• The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses
  A validated tool for assessing case-control and cohort studies.
• LEGEND Evidence Evaluation Tools
  A series of critical appraisal tools from the Cincinnati Children's Hospital. Contains tools for a wide variety of study designs, including prospective, retrospective, qualitative, and quantitative designs.
• JBI Critical Appraisal Tools
  Critical appraisal tools for quality assessment of a wide variety of study designs.

Cross-Sectional Studies

• STROBE Checklist
  A checklist for quality assessment of case-control, cohort, and cross-sectional studies
• LEGEND Evidence Evaluation Tools
  A series of critical appraisal tools from the Cincinnati Children's Hospital. Contains tools for a wide variety of study designs, including prospective, retrospective, qualitative, and quantitative designs.

Diagnostic Studies

• CASP- Diagnostic Studies
  A checklist for diagnostic studies created by the Critical Appraisal Skills Program (CASP)
• QUADAS-2
  A quality assessment tool developed by a team at the Bristol Medical School: Population Health Sciences at the University of Bristol
• JBI Critical Appraisal Tools
  Critical appraisal tools for quality assessment of a wide variety of study designs.
• Scottish Intercollegiate Guidelines Network (SIGN)
  Checklists for quality assessment

Mixed Methods

• McGill Mixed Methods Appraisal Tool (MMAT) 2018 User Guide
  See full site for additional information, including FAQ's, references and resources, earlier versions, and more.
• LEGEND Evidence Evaluation Tools
  A series of critical appraisal tools from the Cincinnati Children's Hospital. Contains tools for a wide variety of study designs, including prospective, retrospective, qualitative, and quantitative designs.

Qualitative Studies

• CASP- Qualitative Studies
  10 questions to help assess qualitative research from the Critical Appraisal Skills Programme
• LEGEND Evidence Evaluation Tools
  A series of critical appraisal tools from the Cincinnati Children's Hospital. Contains tools for a wide variety of study designs, including prospective, retrospective, qualitative, and quantitative designs.
• JBI Critical Appraisal Tools
  Critical appraisal tools for quality assessment of a wide variety of study designs.